Extended left hepatectomy
With in situ cold perfusion and reconstruction of right hepatic vein and accessory 6/7 vein
00:09 SURGICAL PLANNING
02:55 Left lobe and suprahepatic vena cava mobilization
03:58 Expose bare area of right lobe and mobilization of retrohepatic cava
04:28 Porta dissection
06:26 Liver transection begins and caudate resection
08:21 In situ cold perfusion
09:54 Completing liver transection
10:42 Vascular reconstruction: accessory 6/7 and right hepatic vein
12:19 Closing
Case description
- The patient was a 57 year old woman with a 4 cm hepatocellular carcinoma, identified during investigation of an unrelated problem.
- The tumour had compressed the middle hepatic vein from above, and encroached upon the right and left hepatic veins.
- In order to spare as much liver as possible, and because the left lobe was relatively small, an extended left hepatectomy, with re-implantation of the right lobe via in situ cold perfusion, was planned.
- Transection will remove segments 1, 2, 3, and 4, and portions of segments 7 and 8.
- The right hepatic vein and an accessory 6/7 vein will require reconstruction following transection.
CT Scans (Pre-portal vein embolization)
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CT Scans (Post-portal vein embolization)
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